Hypertonic Saline in Refractory Heart Failure Management

Introduction to Treatment Options

• The American College of Cardiology highlights a gap in formal recommendations for the use of hypertonic saline in refractory heart failure management, with current evidence coming from relatively small studies with methodological limitations 1

Conventional Approaches for Refractory Heart Failure

• The American College of Cardiology recommends meticulous identification and control of fluid retention as a conventional approach for refractory heart failure 2
• Consideration of mechanical methods of fluid removal like hemofiltration is suggested when diuretic resistance is present, along with sodium restriction (to 2g daily or less) and fluid restriction (to 2 liters daily) 3